title: [Regional medical support by management of Percutaneous Endoscopic Gastrostomy(PEG)].
abstract: Percutaneous endoscopic gastrostomy(PEG)is useful for not only enteral nutrition but an early rehabilitation of oral intake. We perform PEG and rehabilitation consistently, and we also exchange a catheter after the patient is discharged from our hospital. Most patients undergo changing a PEG catheter at our hospital. So we can follow them for a long-term. There are four techniques to exchange a PEG catheter. We performed exchanging a catheter for 156 patients. There were no major complications to the patients. Merit of the first method, sky-blue method, is that we could change by bed side with almost no invasion. However, we could not get an image of a catheter in the stomach. By the second method, fluoroscopy, we could make an exact image, but a patient had little invasion of moving to an X-ray room, accepting contrast medium, and having Xray exposure. The third method, oral endoscopy, is most reliable for a confirmation of a catheter, but it is most invasive. The fourth method, battery type endoscopy, is less invasive than the third method. We could change a catheter by bed side and use an endoscope as a guiding introducer, and get an image of inside the stomach. We need an imaging diagnosis for getting a confirmation. A battery type endoscopy, which is easily manipulated, is expected to be widely used both in the hospital care and the home nursing care.
authors.affiliation: Dept. of Neurosurgery, Ebina Medical Support Center.
authors.forename: Chie
authors.initials: C
authors.lastname: Mihara
authors.forename: Masuki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yasue
authors.initials: Y
authors.lastname: Hotehama
mesh_terms: D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D005851:Geriatric Nursing; D006699:Home Care Services; D006760:Hospitalization; D010348:Patient Care Team; D000078329:Workforce